Changes from 1986 to 2018 in the prevalence of obesity and overweight, metabolic control and treatment in children with type 1 diabetes mellitus in a Mediterranean area of Southeast Spain

BMC Pediatr. 2022 May 12;22(1):274. doi: 10.1186/s12887-022-03330-1.

Abstract

Background: In recent decades, a global increase in the prevalence of childhood overweight and obesity has been observed in children and adolescents with type 1 diabetes.

Methods: This retrospective, cross-sectional, population study examined three groups (1986, 2007, and 2018) of children and adolescents aged < 16 years diagnosed with type 1 diabetes. Overweight and obesity were defined according to the World Health Organization recommendations.

Results: The prevalence of overweight and obesity in diabetic children and adolescents was 30.2% (95% CI: 23.1-38.3). There was a significant increase from 1986 to 2007 (11.9% to 41.7%, p = 0.002) and from 1986 to 2018 (11.9% to 34.8%, p = 0.012), but no significant differences were found from 2007 to 2018 (41.7% to 34.8%, p = 0.492). The age at diagnosis was lower in the group with excess body mass (p = 0.037). No significant differences were observed in age (p = 0.690), duration of diabetes (p = 0.163), distribution according to sex (p = 0.452), metabolic control (HbA1c, p = 0.909), or insulin units kg/day (p = 0.566), between diabetic patients with overweight or obesity and those with normal weight. From 2007 to 2018, the use of insulin analogs (p = 0.009) and a higher number of insulin doses (p = 0.007) increased significantly, with no increase in the prevalence of overweight and obesity.

Conclusions: The prevalence of overweight and obesity in diabetic children and adolescents increased in the 1990s and the beginning of the twenty-first century, with stabilization in the last decade. Metabolic control and DM1 treatment showed no association with this trend.

Keywords: Adolescence; Childhood; Obesity; Overweight; Type 1 diabetes mellitus.

MeSH terms

  • Adolescent
  • Body Mass Index
  • Child
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1* / complications
  • Diabetes Mellitus, Type 1* / drug therapy
  • Diabetes Mellitus, Type 1* / epidemiology
  • Humans
  • Insulins*
  • Overweight / complications
  • Pediatric Obesity* / complications
  • Pediatric Obesity* / epidemiology
  • Prevalence
  • Retrospective Studies
  • Spain / epidemiology

Substances

  • Insulins